Healthcare Provider Details

I. General information

NPI: 1740925171
Provider Name (Legal Business Name): SOMERSET CARDIOCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2022
Last Update Date: 04/29/2022
Certification Date: 04/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1130 US HWY 202 SOUTH BUILDING E SUITE 3
RARITAN NJ
08869-1490
US

IV. Provider business mailing address

215 BERKLEY AVE
BELLE MEAD NJ
08502-4650
US

V. Phone/Fax

Practice location:
  • Phone: 908-662-6444
  • Fax: 908-662-6445
Mailing address:
  • Phone: 908-227-6470
  • Fax: 908-662-6445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. CHANDRESHWAR N SHAHI
Title or Position: OWNER
Credential: MD, FACC
Phone: 908-227-6470